Even when you enroll in Medicare, your out-of-pocket costs, including deductibles, co-insurance and co-pays can be significant. This is especially true in Minnesota where health insurance premiums vary based on location and population density. It is important to consider options that can help reduce your out-of-pocket costs. Medicare supplements (also known as Medigap), Medicare managed-care style health plans (Advantage and Cost plans) and Part D plans can provide you the coverage and protection you may need. These additional plans must be approved by the Minnesota Department of Insurance, so you can rest assured that all plans meet the established criteria.

Medicaid is a wide-ranging, jointly funded state and federal health care program for low-income individuals of all ages. However, this page is focused on Medicaid eligibility for Minnesota elderly residents, aged 65 and over, and specifically for long term care, whether that be at home, in a nursing home, in an adult foster care home, or in an assisted living facility.

When people were first shown how to qualify for Medicaid in Minnesota in January of 1996, Minnesota was one of the first six states to put the healthcare scheme into action. Minnesota has always put the needs of residents first when laying the ground rules for Medicaid benefits and the state has been controlling costs through the implementation of Pre-paid Medical Assistance Programs, better known as PMAP Medicaid benefits.


If you have health coverage through current employment (either through your work or your spouse’s employer), you may decide to delay Medicare Part B enrollment. You should speak with your employer’s health benefits administrator so that you understand how your current coverage works with Medicare and what the consequences would be if you drop Medicare Part B.
Medicare2019.com is a privately owned website and is not associated, endorsed or authorized by the Center for Medicare and Medicaid Services or any other government entity. This site contains basic information about Medicare, services related to Medicare, private medicare, Medigap and services for people with Medicare. If you would like to find more information about the Government Medicare program please visit the Official US Government Site: at www.medicare.gov

Final decisions haven’t been made on exactly which counties in Minnesota will lose Cost plans next year, the government said. But based on current figures, insurance companies expect that Cost plans are going away in 66 counties across the state including those in the Twin Cities metro. They are expected to continue in 21 counties, carriers said, plus North Dakota, South Dakota and Wisconsin.


Surprisingly, a large percentage of these new enrollees were not newly eligible. In fact, they had always been eligible, they just were not well-versed on the topic of “What are the Medicaid application guidelines?” Enrollment figures shrunk from 1,066,787 to 1,019,309 by August 2015, before creeping back up to 1,026,023 in July the following year.
Medicare Part D is optional prescription drug coverage. If you have Original Medicare, you can get this coverage through a Medicare Prescription Drug Plan, offered through private Medicare-approved insurance companies. These plans offer stand-alone prescription drug coverage that work alongside Original Medicare, Part A and Part B. A Medicare Advantage Prescription Drug plan also provides the Medicare Part D benefit, covering all Medicare benefits under a single plan.
“It’s important for consumers to review their Medicare coverage and make sure the plan is both affordable and provides access to doctors, clinics, hospitals and pharmacies they want and need,” said Kari Benson, executive director of the Minnesota Board on Aging, which operates the Senior LinkAge Line. “Line specialists can help by providing comprehensive, unbiased Medicare counseling.”
The state was the first to participate in a demonstration program to pilot Medicare Cost plans in the 1970s, and the plans have remained popular over the decades. They didn’t catch on in many other states, however, and Medicare + Choice came on the national scene in the 1990s, replaced by Medicare Advantage in 2003 (there are still Medicare Cost plans in Arizona, California, Colorado, District of Columbia, Florida, Iowa, Maryland, North Dakota, Nebraska, New York, South Dakota, Texas, Virginia, and Wisconsin, but their total enrollment was only about a third of the 625,072 people who had Medicare Cost plans in 2018 — the other two-thirds were in Minnesota).

“What are the requirements for Medicaid in Minnesota?” is a question that many Minnesotans seeking medical coverage may be asking. Candidates who learn how to qualify for Medicaid will improve their chances of a successful application. Minnesota’s Medicaid program, referred to as Medical Assistance (MA), is intended for families and individuals with a financial situation that could be classified as low-income. Most individuals who qualify for Medical Assistance get health care through different health plans. Participants can select a health plan that makes sense for them. Participants who opt to not enroll in a health plan can still receive care, but they will pay on a fee-for-service basis, with health care providers billing the state of Minnesota directly for any services they provide. Understanding Medicaid benefits eligibility guidelines is integral to ensuring that qualified candidates are able to receive assistance. When a candidate meets all Medicaid eligibility requirements, MA provides different types of comprehensive coverage. There are income requirements for Medicaid in Minnesota, just like any other state. Petitioners wanting to know who is eligible for Medicaid in MN can find answers by reviewing the information below. 

HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, Medicaid or an individual health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan.
In order to help seniors look for the best Minnesota Medicare supplemental insurance and save the most money, you can search online. Instead of wasting gas, money, and time going from provider to provider, you can look at many different supplemental insurance policies side by side online. You can compare these quotes for supplemental insurance until you find the one that is right for you and your current budget. You will be able to use the money that you save on things that you would rather use it on in Minnesota.
Final decisions haven’t been made on exactly which counties in Minnesota will lose Cost plans next year, the government said. But based on current figures, insurance companies expect that Cost plans are going away in 66 counties across the state including those in the Twin Cities metro. They are expected to continue in 21 counties, carriers said, plus North Dakota, South Dakota and Wisconsin.
You can have a Medicare Advantage plan that is integrated with MA coverage. These plans include all the coverage that Medicare Parts A, B, and D offer plus what MA covers. They are called Special Needs Plans (SNP) plans if you are 18 – 64 years old; Minnesota Senior Health Options (MSHO) if you are 65 or older. With these plans, there’s less paperwork (you only have one insurance card) and you don’t have to worry so much about which of your benefits pays for which medical services. They also offer care coordination as a core part of the plan.
Not surprisingly, the popularity of Medicare Advantage plans varies significantly from one state to another, with only one percent of the Medicare population enrolled in Advantage plans in Alaska (there are no individual Medicare Advantage plans available at all in Alaska; people with Advantage coverage there have employer-sponsored Medicare Advantage plans), versus 56 percent in Minnesota.
We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227.
Final decisions haven’t been made on exactly which counties in Minnesota will lose Cost plans next year, the government said. But based on current figures, insurance companies expect that Cost plans are going away in 66 counties across the state including those in the Twin Cities metro. They are expected to continue in 21 counties, carriers said, plus North Dakota, South Dakota and Wisconsin.
Medicare Part D is optional prescription drug coverage. If you have Original Medicare, you can get this coverage through a Medicare Prescription Drug Plan, offered through private Medicare-approved insurance companies. These plans offer stand-alone prescription drug coverage that work alongside Original Medicare, Part A and Part B. A Medicare Advantage Prescription Drug plan also provides the Medicare Part D benefit, covering all Medicare benefits under a single plan.
Medicare overview information on this website was developed by the Blue Cross and Blue Shield Association to help consumers understand certain aspects about Medicare. Viewing this Medicare overview does not require you to enroll in any Blue Cross Blue Shield plans. To find out about premiums and terms for these and other insurance options, how to apply for coverage, and for much more information, contact your local Blue Cross Blue Shield company. Each Blue Cross Blue Shield company is responsible for the information that it provides. For more information about Medicare including a complete listing of plans available in your service area, please contact the Medicare program at 1-800-MEDICARE (TTY users should call 1-877-486-2048) or visit www.medicare.gov.
Each year, most Medicare beneficiaries should receive their Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) from their existing Medicare Advantage and Medicare Part D plan providers by Sept. 30. CMS makes information available to the public on Medicare.gov in October. The Medicare website is also a tremendous asset for individuals with questions about Medicare rules, timelines, Medicare Part D, etc.
Local HMO plans may require referrals to see a specialist, but some Local HMO Medicare Advantage plans include a point-of-service self-referral option, which gives you some flexibility with going to out-of-network providers. Point-of-Service (POS) plans have an option that allows visits to out-of-network providers at an additional cost. If the POS plan offers Medicare Part D coverage, enrollees must get it from the POS plan. If you enroll in a stand alone plan, you will be disenrolled from the Local HMO Medicare Advantage plan.
Minnesota law prevents Medigap insurers from imposing pre-existing condition waiting periods if the enrollee signs up during their initial six-month open enrollment window. For those who apply after that, Medigap insurers are not allowed to impose pre-existing condition waiting periods if the enrollee wasn’t diagnosed or treated for the condition in the 90 days prior to enrolling in the Medigap plan.
The table below presents the most recent, point-in-time count of total Medicaid and CHIP enrollment in   for the last day of the indicated month, and is not solely a count of those newly enrolled during the reporting period. For purpose of comparison, the table also presents (a) the change in enrollment since the initial open of the Health Insurance Marketplaces, and (b) national counts and change statistics for the same period.
People in a Medicare health or prescription drug plan should always review the materials their plans send them, like the “Evidence of Coverage” (EOC) and “Annual Notice of Change” (ANOC). If their plans are changing, they should make sure their plans will still meet their needs for the following year. If they’re satisfied that their current plans will meet their needs for next year and it’s still being offered, they don’t need to do anything.
The table below presents the most recent, point-in-time count of total Medicaid and CHIP enrollment in   for the last day of the indicated month, and is not solely a count of those newly enrolled during the reporting period. For purpose of comparison, the table also presents (a) the change in enrollment since the initial open of the Health Insurance Marketplaces, and (b) national counts and change statistics for the same period.
Federal guidelines call for an annual open enrollment period (October 15 to December 7) for Medicare Advantage and Medicare Part D coverage in every state. And as of 2019, there’s also a Medicare Advantage open enrollment period (January 1 through March 31) that allows people who already have Medicare Advantage to switch to a different Advantage plan or switch to Original Medicare. But while these provisions apply nationwide, plan availability and price are different from one state to another.
Since 1997, Minnesota has provided Medicare coverage for approximately 35,000 Medicare-Medicaid eligible individuals over age 65 through the Minnesota Senior Health Options (MSHO) program. Today, the Minnesota demonstration recognizes this program stability and is focused on administrative flexibility rather than developing a new capitated system. The current demonstration will be evaluated for its ability to further promote integration. However, the longevity of the MSHO program provides for unique data analysis opportunities. MSHO claims data are a rich resource for researchers to analyze the impact of integrated care on health care outcomes for Medicare-Medicaid eligible.  To that end, the Office of the Assistant Secretary for Planning and Evaluation (ASPE) published Minnesota Managed Care Longitudinal Data Analysis which highlights the importance of providing integrated options for Medicare-Medicaid eligible individuals. It may be found at this link: https://aspe.hhs.gov/report/minnesota-managed-care-longitudinal-data-analysis
HealthMarkets Insurance Agency, Inc. is licensed as an insurance agency in all 50 states and DC. Not all agents are licensed to sell all products. Service and product availability varies by state. Sales agents may be compensated based on a consumer’s enrollment in a health plan. Agent cannot provide tax or legal advice. Contact your tax or legal professional to discuss details regarding your individual business circumstances. Our quoting tool is provided for your information only. All quotes are estimates and are not final until consumer is enrolled. Medicare has neither reviewed nor endorsed this information.

Eagan-based Blue Cross and Blue Shield of Minnesota says it's seen a net increase in Medicare enrollment of about 4,500 people during 2019, with most activity coming from people moving into Medigap plans. The insurer says that many Cost plan enrollees found the closest fit to their old coverage is original Medicare plus a Medigap supplemental plan plus stand-alone Part D drug coverage.

When you are searching for supplemental Medicare insurance policies, you will have many different choices. The best place to look for your supplemental Medicare insurance will be right here online. You will be able to shop through the most inexpensive quotes available right now and can find your Minnesota Medicare supplemental insurance at a very reasonable price. You will not have to waste your time trying to find what you are looking for because what you are looking for will be presented to you here online. But that does not mean that you should choose the first plan that you come across.
Enrollment issues can also be classed as a qualifying event for Medicaid benefits in MN. To avoid delays and confusion regarding the requirements for Medicaid, it might be worth paying for a short-term health insurance policy until enrolment for Medicaid application guidelines opens again. So long as beneficiaries are aware of how to qualify for Medicaid in Minnesota, financial woes and health worries can become a thing of the past.
Not surprisingly, the popularity of Medicare Advantage plans varies significantly from one state to another, with only one percent of the Medicare population enrolled in Advantage plans in Alaska (there are no individual Medicare Advantage plans available at all in Alaska; people with Advantage coverage there have employer-sponsored Medicare Advantage plans), versus 56 percent in Minnesota.
The table below provides a quick reference to allow seniors to determine if they might be immediately eligible for long term care from a Minnesota Medicaid program. Alternatively, one might want to take the Medicaid Eligibility Test. IMPORTANT, not meeting all the criteria below does not mean one is not eligible or cannot become eligible for Medicaid in Minnesota. More.

Unlike Medical Assistance, MNCare has a small monthly premium that ranges as high as $80, but calculated on a sliding scale and not applicable to some enrollees. The preferred enrollment method is through MNsure. Like Medical Assistance, enrollment in MinnesotaCare is open year-round. By September 2016, average monthly enrollment in MinnesotaCare was a little over 100,000. As of 2015, a quarter of the insureds were new enrollees, while the rest were already on MinnesotaCare in 2014.
Most beneficiaries are first eligible to enroll in a Medicare Advantage plan during the Initial Coverage Election Period. Unless you delay Medicare Part B enrollment, this enrollment period takes place at the same time as your Initial Enrollment Period (IEP), starting three months before you have both Medicare Part A and Medicare Part B and ending on whichever of the following dates falls later:
Medicare Savings Programs help people on Medicare pay for some of their out-of pocket Medicare costs. The costs paid depend upon your income but can include Medicare Part A and B premiums, co-insurance, copayments, and deductibles. You need to have countable income that is 135% of the Federal Poverty Guidelines (FPG) or less ($1,366/month for an individual, $1,852/month for couples) to qualify for a Medicare Savings Program.

Minnesota had some of the country’s most generous eligibility guidelines for Medicaid prior to expansion under the ACA (up to 100 percent of poverty for adults with dependent children, and up to 75 percent of poverty for those without dependent children). And the state also became the first in the nation to establish a Basic Health Program under the ACA.
DFL lawmakers and Gov-elect Tim Walz are considering various possibilities for a MinnesotaCare buy-in program that would open the coverage up (for a price) to anyone buying their own coverage, or to people in areas of the state where there are limited plan options available in the individual market. The details haven’t been worked out yet, but this is something to watch in Minnesota in 2019.
Countable assets include cash, stocks, bonds, investments, credit union, savings, and checking accounts, and real estate in which one does not reside. However, for Medicaid eligibility, there are many assets that are considered exempt (non-countable). Exemptions include personal belongings, household furnishings, an automobile, irrevocable burial trusts, and one’s primary home, given the Medicaid applicant or their spouse lives in the home and the equity value is under $585,000 (in 2019). For married couples, as of 2019, the community spouse (the non-applicant spouse) can retain up to a maximum of $126,420 of the couple’s joint assets, as the chart indicates above. This, in Medicaid terminology, is referred to as the Community Spouse Resource Allowance (CSRA).

County WorkersThere is a local human services office in each county with workers that help residents fill out and submit MN Medicaid applications. These workers are trained and have information about Medical Assistance. If you have questions about other available health programs, they can direct you to someone that can help.Below is an overview of how MNsure navigators and county workers can help you with your Medicaid application.Navigators Can:
Some programs help people who have little to no income. Examples of people these programs may serve include seniors and those unable to work because of serious illness. Other programs help people who work but do not have access to affordable health insurance. People these programs serve include those who are working one or more jobs but do not get health insurance through their jobs. They also include farmers and other self-employed people.
One of the reasons Medicare Cost has been so popular in Minnesota is that the state has a large population of “snowbirds” — retirees who live in Minnesota during the summer, but head south to warmer climes in the winter. With Medicare Cost plans, the enrollee still has Original Medicare — including the large nationwide network of providers who work with Medicare — in addition to the Medicare Cost coverage. Medicare Advantage plans, in contrast, tend to have localized networks that might not be suitable for a senior who lives in two different states during the year. A Medigap plan plus Original Medicare will allow a person in that situation to have access to health providers in both locations, although Medigap tends to be more expensive than Medicare Advantage. There are pros and cons to both options, and no one-size-fits-all solution.
Private managed care programs for Medicare beneficiaries are particularly popular in Minnesota. Fifty-six percent of all Minnesota Medicare enrollees were enrolled in private Medicare plans in 2017, as opposed to a national average of 33 percent. Minnesota has by far the largest share of its Medicare population enrolled in private plans; the next closest state is Hawaii, where 45 percent of Medicare beneficiaries have private coverage.
Medicare Supplement insurance plans (or Medigap) are voluntary, additional coverage that helps fills the gaps in coverage for Original Medicare. The best time to enroll in a Medicare Supplement insurance plan is during your individual Medigap Open Enrollment Period, which is the six-month period that begins on the first day of the month you turn 65 and have Medicare Part B. If you decide to delay your enrollment in Medicare Part B for certain reasons such as having health coverage based on current employment, your Medigap Open Enrollment Period will not begin until you sign up for Part B.

If you’re automatically enrolled in Medicare Part B, but do not wish to keep it you have a few options to drop the coverage. If your Medicare coverage hasn’t started yet and you were sent a red, white, and blue Medicare card, you can follow the instructions that come with your card and send the card back. If you keep the Medicare card, you keep Part B and will need to pay Part B premiums. If you signed up for Medicare through Social Security, then you will need to contact them to drop Part B coverage. If your Medicare coverage has started and you want to drop Part B, contact Social Security for instructions on how to submit a signed request. Your coverage will end the first day of the month after Social Security gets your request.
Are you tired of paying for all of your healthcare costs? Even if you are under certain Medicare Advantage plans, you can still be on the hook for a lot of costs. Luckily, we can help you find the best Medicare Advantage plans in Minnesota for 2019 that will help you pay for these expenses. Then, you can enjoy retirement instead of worrying so much about money concerning your healthcare.
Since 1997, Minnesota has provided Medicare coverage for approximately 35,000 Medicare-Medicaid eligible individuals over age 65 through the Minnesota Senior Health Options (MSHO) program. Today, the Minnesota demonstration recognizes this program stability and is focused on administrative flexibility rather than developing a new capitated system. The current demonstration will be evaluated for its ability to further promote integration. However, the longevity of the MSHO program provides for unique data analysis opportunities. MSHO claims data are a rich resource for researchers to analyze the impact of integrated care on health care outcomes for Medicare-Medicaid eligible.  To that end, the Office of the Assistant Secretary for Planning and Evaluation (ASPE) published Minnesota Managed Care Longitudinal Data Analysis which highlights the importance of providing integrated options for Medicare-Medicaid eligible individuals. It may be found at this link: https://aspe.hhs.gov/report/minnesota-managed-care-longitudinal-data-analysis
Another wrinkle is that people who want a supplement might have a better chance of getting into the coverage during the transition out of their Medicare Cost plan, when the supplement is provided on a “guaranteed issue” basis. Later, insurance companies can ask questions about a senior’s health status and deny coverage depending on the answers, said Greiner of the Minnesota Board on Aging.
But once that window closes, enrollees often find themselves locked into the plan they have – regardless of how the premium changes – because in most states, switching to another plan can be impossible or prohibitively expensive due to medical underwriting. (Under federal guidelines, there are seven limited circumstances when you can get a new Medigap plan without medical underwriting.)
Minnesota made history for kick-starting the Basic Health Program before any other state in the nation. People who are curious about “what are the Medicaid application guidelines?” will be interested to learn that prior to expansion, the process of learning how to qualify for Medicaid in MN was much more generous than it is now. The Medicaid benefits eligibility rules for adults with dependent children used to be up to 100 percent of poverty or 75 percent for adults without dependents.
“What is Medicaid eligibility?” This question may be on your mind if you are new to the program. MN Medicaid eligibility is generally determined by the income level of the individual or household applying for Medical Assistance (MA). Individuals and families that fall within the allowable income range are eligible to receive benefits. In order to qualify for the program all applicants must meet all income and any other requirements.
Missouri Medicare Supplement Anniversary Guaranteed Issue Period – Page 8 of this guide gives more information about the unique enrollment opportunity that allows Medicare beneficiaries with a Medicare Supplement (Medigap) Plan to switch their same policy from a different carrier without having to undergo medical underwriting. It begins 30 days before the issue date of the beneficiary’s current policy, and ends 30 days after the issue date.
Only one switch during this time frame is allowed each year — you can change your mind multiple times during the enrollment period in the fall, but can only switch to a different Medicare Advantage plan (or back to Original Medicare) once in the first quarter of the new year. But if you sign up for a Medicare Advantage plan in the fall and then decide you don’t like it once it takes effect in January, you have until the end of March to make a change.
You can only sign up for Part D coverage during the first three months of the year if you’re switching from a Medicare Advantage plan back to Original Medicare. You cannot, for example, be enrolled in Original Medicare with a Part D plan and then switch to a different Part D plan during the January – March enrollment period. Instead, you’d need to make that change during the fall election period (October 15 to December 7).
Countable assets include cash, stocks, bonds, investments, credit union, savings, and checking accounts, and real estate in which one does not reside. However, for Medicaid eligibility, there are many assets that are considered exempt (non-countable). Exemptions include personal belongings, household furnishings, an automobile, irrevocable burial trusts, and one’s primary home, given the Medicaid applicant or their spouse lives in the home and the equity value is under $585,000 (in 2019). For married couples, as of 2019, the community spouse (the non-applicant spouse) can retain up to a maximum of $126,420 of the couple’s joint assets, as the chart indicates above. This, in Medicaid terminology, is referred to as the Community Spouse Resource Allowance (CSRA).
You may qualify for a special enrollment period if you delayed Part B because you or your spouse had medical coverage through an employer or union, or if you cancelled Part B coverage because you went back to work with group medical coverage. The special enrollment period lasts eight months (it begins when your employer coverage ends, or when your employment ends – whichever is first). Request a form from your employer to begin your special enrollment period, and then send the form with your Part B Enrollment form to Social Security. If you continue your employer coverage through COBRA, you should enroll in Medicare Part B during the first three months of your COBRA coverage to avoid the late enrollment penalty.
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